The Regulation and Quality Improvement Authority (RQIA) has responded to a number of enquiries around the decision to close the Valley Nursing Home in Clogher.

Among the answers, it has emerged of the two Health and Social Care Trusts responsible for patients in the facility, only one raised a concern over care prior to closure.

The move caused upset and confusion for residents and their relatives who have struggled to get answers for almost two years, and it was only recently they were provided with a report from a Lessons Learned Review, which to that point they didn’t even know had taken place.

Of the 53 residents, in the immediate aftermath of transfer, 14 residents died. Six who had already been moved within the Western Health and Social Care Trust area also died. Some residents without Covid-19 were moved to other care homes with active pandemic outbreaks.

The RQIA were asked if the action was deemed an emergency closure and as both the Southern Health and Social Care Trust and Western Health and Social Care Trust were responsible for residents, were concerns raised over the level of care at any time, but specifically in the two years running up to and during the closure?

In a comprehensive response, a spokesperson said prior to closure, the RQIA was contacted by the Southern Trust on one occasion with concerns about the quality of the service, which were followed up through an inspection several days later.

There were no recorded concerns raised by the Western Trust.

During the two years prior to closure, the RQIA was contacted on 12 occasions by family members and former staff who raised issues relating to care, staffing issues, management, hygiene, environment, and RQIA’s enforcement action.

In each case, these were followed up by RQIA’s inspector with the management of the service or via Health and Social Care Trusts.

The spokesperson added: “On October 21, 2020, RQIA conducted an unannounced inspection at Valley Nursing Home.

“As a result of significant breaches of Nursing Home Regulations identified during this inspection, on November 4, 2020, RQIA issued notice of a proposal to cancel the registration of the Responsible Individual for Healthcare Ireland Belfast Limited as the provider registered of Valley Nursing Home, Clogher.

“These included serious concerns in relation to the health, welfare and dignity of residents, management and governance arrangements, and adherence to infection prevention and control requirements.”

However, the RQIA stressed the move “was not an emergency closure”, continuing: “Enforcement action commenced on November 4, 2020, and took effect with closure on January 7, 2021.”

This is at odds with the content of the Lesson Learned Review report, which is the only time the term ‘emergency closure’ was ever used during the entire process.

Under the heading ‘Additional Costs’, the report states: “The emergency notice of closure of the Valley Care [sic] Home meant that alternative placements had to be sourced very quickly.

“Given the complex needs of many of the residents, the available beds across the system that were able to meet these needs cost considerably more per week than the regional tariff, or the agreed costs for a placement in the Valley.”

The Department of Health Press Office refused to explain why the term ‘emergency’ closure was used, instead instructing this and all further enquiries on the Valley Nursing Home should be submitted as Freedom of Information requests.

This was done, and in a very swift turnaround, potentially indicating the Press Office could have answered the question without difficulty, the Department contended use of the term ‘emergency’ in the emergency notice of closure related to “the unfolding situation and the short timeframe in which alternative accommodation had to be found for residents”.

The Department has yet to provide the Terms of Reference for the report, as well as the dates it was drafted, approved and signed off.